Advanced liver disease and portal hypertension may produce various intratho
racic complications that involve the pleural space, lung parenchyma, and pu
lmonary circulation. Dyspnea and arterial hypoxemia are the common clinical
symptoms and signs in patients with such complications. In these patients,
intrathoracic complications most often develop during the course of hepati
c disease, but a few patients may be seen first with respiratory symptoms o
r radiographic abnormalities. Therefore, radiologists should be made aware
of these disorders that occur in patients with chronic liver disease. In th
is article, the authors describe and illustrate the clinical and imaging sp
ectrum of thoracic abnormalities associated with advanced liver disease and
portal hypertension.